Acute renal failure

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Purred: Fri Jan 20, '12 12:45pm PST 
its been a while since I got on here and I'm not sure anyone knows who I am.
My cat, Lemmy, was diagnosed with kidney disease over 2 years ago. His BUN/creatinine levels weren't very high, but they were above normal. Over the past 2 years, the only thing that changed what his blood pressure (for which he started meds for). His BUN/creat never really changed.
3 days ago, he stopped eating his dry kibble. I soaked it and got him to eat a few bites and noted an odor coming from his mouth. After taking him to the clinic, the doctor confirmed that his mouth looked fine and ran bloodwork/urine. I left him there overnight and got the results back this morning. His creatinine had previously never gone above 3.4, and it is now over 6. His phosphorous levels are elevated for this first time and he has a slight infection.
Lemmy is 16 years old and is well known for his incredibly short fuse (...the last time they tried to get an IV in him they had to give up after 2 doses of torb and 3 techs). When he's not screaming and trying to eat people, he's a very sweet, happy old cat.
At the moment, they are trying to get him on an IV and culture his urine so that they can give him specific antibiotics in hope that the infection is causing his creatinine to be so high. He's still not eating, though, despite pepcid, cerenia, and another injection.

At the moment, I'm hoping antibiotics will make him feel better, but if they don't, his prognosis is very poor.

As he has aged, he has gotten nicer and happier. It's impossible for me to tell if he is uncomfortable or distressed due to his euphoria. I don't think he's going to give me any indication of when it's time for him to go... and I don't know how to decide for him when it's time to quit. (my thoughts on euthanizing are that if an animal is not happy/comfortable 50% of the time and nothing can be done to make them more comfortable, then it's time)

Has anyone had to make this decision? I just want what is best for Lemmy..

Bella My- Beautiful- Angel

Mommys Kitty- Girl! I know- I\'m loved!
Purred: Fri Jan 20, '12 1:41pm PST 
My Bella has chronic kidney issues. She's on subq fluids daily and she also gets pepdid 2 a day and azodyl 2 a day and now renavast 2x a day.
We also have her on a wonderful appitite booster that Kaci Sunshine's mom told us abuot and it does wonders!

Bella is jsut now fighting an infection as well. My vet said it's that the kidney's not working properly can sometimes bring their immune systems into compromise as well.

I would say so long as your kitty is eating some, drinking, peeing and pooping, it's a good sign. Dry food isn't great for kitties with kidney stuff we were told. Bella does have access to it, but as she has gotten older she is eaten less dry and more canned.

Hope this helps!

Kaci- Sunshine - Beloved- Angel

Sugar 'n Spice
Purred: Fri Jan 20, '12 4:18pm PST 
Photon, cats with CKD can get that smell in their mouths and it's a sign that something is very wrong. It's a good thing you were attentive and took Lemmy to the vet.

The same thing happened to Kaci. She was initially diagnosed with kidney insufficiency. Then suddenly, for no apparent reason, her creatinine and BUN suddenly escalated and her kidneys began crashing. She was hospitalized and put on IV fluids. The docs suspected a kidney infection. The urine culture came back negative but it often comes back negative in cats who have kidney infections. The only confirmation of sorts was what they found on her ultrasound --they found dilation of the renal pelvis (that’s the curve in the kidneys) consistent with a bilateral kidney infection. She took an antibiotic for 6 weeks and got subq fluids every other day and the infection cleared up.

Now I'm left dealing with the ups and downs of daily management of her CKD . She gets subq fluids every day, along with Pepcid and an occasional appetite stimulant, which helps a lot. Believe me, I never thought Kaci was a good candidate to get meds and subq fluids every day and was afraid the stress would impinge on her quality of life. But somehow or other, we're managing. She's surprisingly cooperative about getting the subq fluids. And I had all of her medications made into transdermal ear gels and that's helped lower the stress level a lot!

I agree with everything Bella wrote and also that dry food isn't optimal for cats with kidney disease and wet food is the best. However, if Lemmy will only eat dry food, then feeding dry food is better than having him not eat! Starvation is a major concern and leading cause of death with CKD cats and I've always been advised to feed Kaci whatever she'll eat.

Purring that Lemmy is soon feeling better!

(had to edit this post twice . . . seems I can't spell LOL!)

Edited by author Fri Jan 20, '12 4:22pm PST



Purred: Fri Jan 20, '12 11:24pm PST 
Thanks for the response smile

Lemmy's BUN/creatinine have always stayed about the same since he was first diagnosed, but now everything is ridiculously high.
They put him on antibiotics and IV fluids today and he's spending the night at a 24 hour emergency clinic to ensure he continues his fluids. Overall, there hasn't been much change. His phosphorous levels are really high as well, so they are giving him phosphate-binders to try and help.
Lemmy ate dry kibble because he flat out refused any kind of wet food, otherwise I would have had him on a kidney-specific wet food.
He still has almost no appetite, and he's being way too nice (he didnt even need to be sedated for his IV catheter).
The hardest part to determine is his level of distress. Because the worse he feels, the happier he acts. The only indication is the way he looks and pays attention, as though it's just too much effort.
We're taking it day by day, according to the vet. They said that by tomorrow evening we should be able to tell if it's the infection that's making his kidney values appear so bad, or if his kidneys are truly shutting down.

Bella My- Beautiful- Angel

Mommys Kitty- Girl! I know- I\'m loved!
Purred: Sat Jan 21, '12 4:43am PST 
Thinking of you and Lemmy. Beleive me, we can relate. Sometimes we feel we're riding a rollercoaster here...and we are. But there are still more good days than bad days.

Bella this morning ate a little dry KD, and we found that by offering her a variety of canned foods, even sometimes the 'bad' ones she shouldn't have, made her more accceptabel to canned.

We have found that offering things they like...and pampering have helped. We also put her on an appitite stimulant, and it did wonders!


Match made in- Heaven
Purred: Mon Jan 23, '12 1:34pm PST 
This is what I went through with Wilbur last year:

His regular vet thought he was hyperthyroid after he dropped from 16.5 to 12.2 pounds in 15 months. She ran a blood test and was surprised he was negative. Using the same blood sample, a more specialized test was run, which also was negative. So we took him to his dermatologist, who works at a large hospital with a radiology department called MedVet.

The dermatologist told me to keep Wilbur there for an ultrasound, more bloodwork, and a urine test. That was on a Friday so I got the results on Tuesday. He had a liver infection that required two weeks on pills, which was cleared up, and he was reportedly in the "very early stages" of kidney failure. The dermatologist told me Wilbur can still live for a couple more years by eating wet food. Later he ordered the k/d food.

The plan might look good on paper, but changing foods did not help him at all. He kept getting worse anyway. I took him back to MedVet later, where another vet (who he also knew) recommended buying a fountain and talking to his regular vet about the sub-q injections. So we went back to the regular vet thinking she would be able to help.

I was wrong. The regular vet told me Wilbur got worse so fast even the sub-q injections and wet k/d food cannot help him anymore. I could not fight back tears forever as she talked about euthanizing him and cried herself. She labeled the kidney failure "acute chronic" because of how fast it got worse.

From that day until December 1, Wilbur received at-home hospice care - any food he would eat, two Pepcid pills a day, water next to the couch where he slept. Telling this part of the story makes me cry.


Member Since
Purred: Fri Jun 28, '13 12:37pm PST 
My vet said NOT to try Renavast-- that their testing was not anything to speak of,that the values can fluctuate anyway so their claims are worthless. It is not even written up in any of the veterinary journals and the other vets he consulted with all feel the same way...it's shady! Just to make sure, I asked my daughter's friend who is in her second year of veterinary school and she asked around and they said basically the same thing except that it could even be harmful since there is no real good data, and they apparently have been in trouble with the FDA over some of their claims. It's like those fake weight loss medications one sees advertised in the National Enquirer!

Edited by author Fri Jun 28, '13 12:38pm PST



Miss.- Prissy-pants
Purred: Fri Jul 5, '13 11:12pm PST 
Sad to hear so many kitties ill! Pixie was diagnosed with acute renal failure a the end of January this year. It's been a very crazy five months since. I first noticed something was wrong when she stopped sleeping in her normal sleeping spot. Then she became lethargic and didn't want to pick her head up when I gave her a pet. A quick trip to the vet confirmed the worst and several of her levels in her blood work was pretty high. She was luckily not severely dehydrated so I was able to take her home. She's now on three different types of medication, Epakitin powder, Rubenal 75 pills, and Azodyl Capsules twice a day. She turned up her nose completely at the first cans of food that the vet recommended but after I switched food to a different brand she's eating much better. It's never perfect and some days she's a better eater then others. I make sure to give her lots of praise when she finishes all her food. Her personality change has been the biggest thing I've noticed since I started the medication. She's become more social and friendly then she ever had before. She's been doing so well that I'm crossing my fingers that it will continue for a long while yet.